I-Hypertension "J Curve"
"Ugqirha wam waqalisa ukunyanga ngenxa yengcinezelo yegazi ephakamileyo ezintandathu kwiinyanga ezidlulileyo, kwaye ukufundiswa kwam kwahamba kwimizuzu eyi-155/90 ukuya kwi-120/70, endicinga ukuba yayiyinto emangalisayo. Ngoko kwiveki ephelileyo ndandimangaliswe xa ugqirha wandixelela ukuba wayexinzelele ukunyanzeliswa kwegazi lam, kwaye wanciphisa umthamo wam wegazi wonyango. Umbuzo wam kukuba: Yintoni eyithandayo? Ngaphantsi? Ngaba le nto iyinyani, okanye ndifanele ndifumane ngugqirha? "- USidney waseOregon
Njengoko kwenzeka, u-Sidney, ugqirha wakho ubonakala ukuba ufikelele ngoku ubungqina bwakutshanje ngokuphathelele unyango lwexinzelelo. Ubuncinane ubuncinane bokuba kukho uxinzelelo lwegazi oluya kuthathwa njengolukhulu kumntu ongaphathwanga (120/70 umzekelo), unokuba luphantsi kakhulu kumntu kwiinkqubo zonyango lwegazi.
Uxinzelelo lwexinzelelo, okanye uxinzelelo oluphezulu lwegazi, luyimeko yesifo esivamile kakhulu, ukuba, xa ingaphathiswa, ingakhokelela kwisifo se-myocardial (intliziyo yesifo) , ukungaphumeleli kwintliziyo , ukubetha , kunye nesifo sesifo. Ukuba unobungozi begazi kubalulekile ukuba wena nodokotela wakho uthathe amanyathelo afunekayo ukuze unciphise ngokwaneleyo uxinzelelo lwegazi, ngaphambi kokuba umonakalo ongenakunqunyulwa wenziwe entliziyweni yakho, ingqondo okanye izintso.
Le nxalenye ye-equation icacile. Ingxabano ilele kwindlela ekunyanga ngayo unyango lwegazi ophezulu kufuneka iqhutywe.
Ziziphi Iinjongo Zonyango Elifanelekileyo?
Kwiminyaka emininzi, iingcali zengcinezelo yomsindo zandithanda ukuthetha, "Xa kuziwa kwixinzelelo legazi, ezantsi zingcono." Le nkcazo yayihlala yinto yokunyusa, ekubeni ukunciphisa uxinzelelo lwegazi kumazinga aphantsi kakhulu, ngokucacileyo, kunokukhokelela ubukhulu besikhatho okanye okanye syncope .
Kodwa kunikezelwa ukuba umda wokukhawuleza, "uhla olungaphantsi" kubonakala kuyindlela enengqiqo, kuba kubemi jikelele kubaluleke ngokwenene - okuphantsi kweengcinezelo zegazi, isichengeni se-cardiovascular or kidney disease.
Kuye kucatshulwa nje ukuba umgaqo ofanayo kufuneka usebenze kwizigulane ezixinzelelekileyo kunyango.
Emva koko, uphando oluninzi lubonise ukuba xa unciphisa uxinzelelo lwegazi kwizigulane ezinegazi eliphezulu, iziphumo zabo ziphucula kakhulu. Ngoko oogqirha babeziva bekhululekile ukunciphisa iingcinezelo zabo zegazi njengoko banako, ekubeni nje izigulane zabo bezingenayo impawu yokukhanya okanye i- orthostasis .
Yingakho ezininzi iinjongo zonyango zengqondo zonyango zibonakaliswa njengexabiso "elingaphantsi kwexabiso" (njenge-systolic blood pressure engaphantsi kwama-140 mm Hg), esikhundleni sokuba njengoluhlu lwexabiso (njengolu xinzelelo lwe-systolic phakathi kwama-130 ukuya kuma-140 mm Hg) .
Kuye kuphela kwiminyaka yamuva ukuba le "iplastiki engcono" iparadigm ibe phantsi kombuzo omkhulu. Ngoku kubonakala ukuba kunokwenzeka ukunciphisa uxinzelelo lwegazi ngaphantsi kwexabiso elifanelekileyo, kwaye kungenokwenzeka ukuba kuveliswe ingozi ngokwenza njalo.
I-Blood Pressure "J Curve"
Ezinye iziphumo zangoku ziphakanyisile ukuba iziphumo zekliniki kwizigulane eziphathwe ngxinzelelo lwengcinezelo zingalandela "i-curve J," apho iziphumo zibonakala zichanekileyo kwiinkalo ezithile zeengcinezelo zegazi. Ukuba uxinzelelo lwegazi ngexesha lonyango lingaphezulu okanye ngaphantsi kweloluhlu oluphezulu, iziphumo zeklinikhi ziba zibi nakakhulu. Ukuba i-curve ye-J iyinyani, i-paradigm ingamanga - kwaye oogqirha baya kufuna ukuba baqaphele ngakumbi malunga nokuba banciphise kangakanani iimpembelelo zegazi zabo.
Enye yezifundo ezibalulekileyo ezenza leli nqaku lishicilelwe ngo-2014 kwiNcwadi ye-American College of Cardiology. Abaphandi abavela kwi-Southern California Kaiser Group bafumene izigulane ezizigidi kwizigidi eziphethwe ngophezulu lwengqondo, kunye nokuthelekiswa kweengcinezelo zegazi kwiinkqubo zabo zonyango. Bafumene ukuba uxinzelelo lwegazi lwe-systolic ngelixa unyango lwaluphakathi kwe-130 ukuya kwe-139 mm Hg, kwaye i-diastolic yexinzelelo yegazi yayiphakathi kwama-60 ukuya ku-79 mm Hg. Uxinzelelo lwegazi lwangonyango olungaphezulu okanye ngaphantsi kwezi zidibanisi zahlanganiswa neziphumo ezimbi.
Ingcamango ye-J ingaba ibaluleke kakhulu, kwaye ngoku iyakwamkelwa ngokubanzi, kwizigulane ezithe zadala eziye zahlula i-systolic hypertension. Ezinye izikhokelo zangoku zikhuthaza ukuba uxinzelelo lwegazi luphantsi kakhulu kwezi zi gulane, kwaye oogqirha ngoku sele beqaphele ngokunyanga izigulane zabo eziguga ngokweqile.
Sekunjalo, ku funeka kuqatshelwe ukuba izifundo ezininzi ziye zahluleka ukuchonga i-curve ye-J yezigulane ezingezange zikhulile zonyango ngenxa yengozi yomshukela ophezulu, kwaye umbuzo uhlala unengxabano phakathi kweengcali. Kodwa ezininzi iingcali ziye zazingqongqo ngakumbi ekuboniseni ingcamango "engezantsi engcono", kwaye iingcali ezininzi ziza kwamkela ukuba i-curve J iyinyani.
Ngoko, uSidney, isincomo sagqirha sakho sokubuyela kwisifo sakho sengozi yenyango yenyango sihambisana nobungqina bwakutshanje. Siza kufuneka silinde size sibone ukuba iiphaneli zeengcali ezenza izikhokelo zonyango ziya kugcina zibambe naye.
Imithombo:
Sim JJ, Shi J, Kovesdy CP, kunye no-al. Impembelelo yokufezekiswa kweengcinezelo zegazi malunga nobungozi bokufa kunye nesifo sokuphela kwesigxina phakathi kwabantu abaninzi, abahlukahlukeneyo begazi. I-Coll Cardiol. 2014; 64 (6): 588-97 (ISSN: 1558-3597)
UMancia G, uFagard R, uNarkiewicz K, et al. Izikhokelo ze-ESH / ESC ze-2013: Uluhlu lwe-Task Force ekulawuleni uxinzelelo lwegazi lwe-European Society of Hypertension (ESH) kunye ne-European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281.
James PA, Oparil S, uCarter BL, et al. Isikhokelo esisekelwe ku-2014 sobungqina be-blood pressure ephezulu kubantu abadala: ingxelo evela kumalungu eepaneli aqeshwe kwiKomiti yeSizwe yeSizwe eYisibhozo (JNC 8). JAMA 2014; 311: 507.